1. Midland DHBs Board Development
Internal Audit
and
Audit & Assurance
10 April 2017

2. Presentation Contents
Who is Internal Audit?
Who is Audit and Assurance?
Links with DHB Board Sub-committees
Interactive Activity ??
HOW

3. Who are we? – Internal Audit
Midland Region Internal Audit (RIA) Service based in HSL
Five auditor employees located at various DHBs
Several contractors with specialist skills / capabilities and additional / flexible capacity – includes Central TAS

4. What do we wish to achieve for Midland?
Service Vision
The overall role of the RIA service is to provide independent assurance and consulting services to support and monitor
the DHBs’ risk management and internal control activities that have been implemented by management to run their organisations.
HOW
WHAT

5. What do we wish to achieve for Midland?
Service Vision
In providing those services, the team aims to improve the DHBs’ operations and assist them to achieve their objectives.
By reporting directly to the audit committee of the Board for each DHB, the RIA service assists the Board fulfill its core responsibility of governing (administering and controlling) the organisation.
WHY
WHO

6. What do we wish to achieve?
Benefits to the DHBs
Reduction in total regional spend on back office services in the longer term
More effective regional services within the current funding
More formal peer support
Assist with retaining in-region skill (e.g. through broader career opportunities)
DHBs are familiar with multiple auditors
System, process or control requirements collated for all DHBs
Audits facilitate / assist in promoting or driving regional initiatives
Preferred practice easily shared amongst DHBs
Sundry regional initiatives assist audit committees directly

7. Efficient allocation of public health system resources
Internal Audit assists DHB management and governance by developing recommendations for improvement in numerous areas:
The efficiency and effectiveness of a department’s business operations and administrative activities, including service delivery procedures - e.g. by streamlining and/or automating systems, processes and controls
Protection and overall management of medical equipment and other assets – e.g. through sound maintenance, repair, replacement planning and security against theft or misuse
Supplier contract management and monitoring – e.g. by following due procurement processes to ensure best value-for-money

8. Efficient allocation of public health system resources
The provision, accuracy and usefulness of financial, revenue, contract and other information – e.g. to help with key clinical decisions, targets achievement, income and expenditure control
Health and safety management systems – e.g. high quality systems to avoid / minimise health and safety issues, with any subsequent diversion of effort, financial penalties and reputation damage
Maximising / optimising the use made of computer systems available within the organisation – e.g. through optimum use of expensive systems for automation, consistency, standardisation and accuracy
Security and access to the organisation’s information systems – e.g. by minimising system downtime and service disruption then recovery time

9. Efficient allocation of public health system resources
The Midland Regional Services Plan also refers to the need to focus on the following, which the RIA service contributes to:
Innovation – by providing new ideas to resolve old problems, from our RIA service or from other DHBs
Service integration – by encouraging disparate services to work together through our DHB-wide and regional work activities
Reduced waste – in relation to areas such as staff and managers’ time; clinical consumables or assets; misuse or misappropriation of other DHB property (e.g. vehicles, medicines, stationery)

10. Links with DHB Board Sub-committees
DHB Audit Committees links:
Internal Audit updates against the internal audit plan
Internal audit reports
Perform ad-hoc assignments requested by the Committee
One-on-one discussions with External Auditors and Board Members
Audit and Assurance updates on delivery and performance against the annual audit plan
DHB Strategy / Planning and Funding reports on any issues or high risks

11. Audit and Assurance Estb. 2001 de nova 2013 5 DHBs Performance
- NGO contracts Auditing
- Compliance
- Service provision
- Risk assurance
-Provider support
$1.2m -> $0.8m pa
Crown DAA
JASANZ 4Yr!

12. Performance auditing – Future?
Findings (composite):
Purchase of shot guns/nike gym shoes
Incorrect/different service provided
FTE misallocated
Governance failures
Low level Quality systems management
Initiatives - current
He Ritenga
Health & Safety
Multi-agency auditing
From To
delivering contracts improving communities
Focus on activity output outcomes
Focus on DHB multi-agency focus
Low trust contract high trust suppliers

13. Interactive Activity